{"doi":"10.1093/gerona/glac242","title":"Multimorbidity, 30-Day Readmissions, and Postdischarge Mortality Among Medicare Beneficiaries Using a New ICD-Coded Multimorbidity-Weighted Index","abstract":"BACKGROUND: Medically complex, disabled adults have high 30-day readmission rates. However, physical functioning is not routinely included in risk-adjustment models. We examined the association between multimorbidity with readmissions and mortality using a physical functioning weighted International Classification of Diseases (ICD)-coded multimorbidity-weighted index (MWI-ICD) representing 84 conditions. METHODS: We included Medicare beneficiaries with ≥1 hospitalization 2000-2015 who participated in a Health and Retirement Study interview before admission. We computed MWI-ICD by summing physical functioning weighted conditions from Medicare claims. We examined 30-, 90-, and 365-day postdischarge mortality using multivariable logistic regression and length of stay through zero-inflated negative binomials. Models adjusted for age, sex, race/ethnicity, body mass index, smoking status, physical activity, education, net worth, and marital status/living arrangement. RESULTS: The final sample of 10 737 participants had mean ± standard deviation (SD) age 75.9 ± 8.7 years, MWI-ICD 14.9 ± 9.0, and 20% had a 30-day readmission. Adults in the highest versus lowest quartile MWI-ICD had 92% increased odds of 30-day readmission (odds ratio [OR] = 1.92, 95% confidence interval [CI]: 1.65-2.22). A 1-point increase in MWI-ICD was associated with 24% increased odds of 30-day readmission (OR = 1.24, 95% CI: 1.18-1.31). A 1-point increase in MWI-ICD was associated with 32% increased odds of death within 365-day postdischarge (OR = 1.32, 95% CI: 1.25-1.40). Readmitted participants with the highest versus lowest quartile MWI-ICD had 37% increased number of expected hospitalized days (incidence rate ratio = 1.37, 95% CI: 1.17-1.59). CONCLUSION: Among Medicare beneficiaries, multimorbidity using MWI-ICD is associated with an increased risk of readmissions, mortality, and longer length of stay. MWI-ICD appears to be a valid measure of multimorbidity that embeds physical functioning and presents an opportunity to incorporate functional status into claims-based risk-adjustment models.","journal":"The Journals of Gerontology Series A","year":2022,"id":268530,"datarank":0.24141568686511508,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9444,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":48899,"name":"Melissa Y. Wei","orcid":"0000-0001-5093-6040","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:27:14.088663Z","pmid":"36480692","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}